Tracheal bronchus: a rare cause of recurrent pneumonia in adults

Abstract

Tracheal bronchus, also known as bronchus suis, is a rare congenital anomaly of the airway where an accessory bronchus originates directly from the trachea. With an estimated incidence of 0.001%-2.0%, this condition is rarely reported in literature. It is usually discovered as an incidental finding in an otherwise asymptomatic individual. However, it can act as a focus of recurrent infection or present as persistent radiographic infiltrates. Multidetector CT imaging and bronchoscopy play a crucial role in the identification of this entity. We hereby report the case of a middle-aged man who presented with recurrent right upper lobe pneumonia, which was found to be due to an underlying tracheal bronchus.

Keywords: Pneumonia (respiratory medicine); Radiology; Respiratory medicine.

Figure 1

Chest X-ray (posteroanterior view) showing right upper lobe cavitation and cystic changes and bilateral upper and middle zone non-homogenous opacities, more on the right side.

Figure 2

Coronal (A) and axial (B) sections of CT thorax showing areas of consolidation with internal cavitation in apical segment of right upper lobe, with bronchiectasis, bilateral fibrocalcific patches and centriacinar emphysema. Tracheal bronchus is seen arising directly from the right lateral tracheal wall (arrow) and supplying the right upper lobe.

Figure 3

Fibreoptic videobronchoscopy image showing a 1×1 cm round opening approximately 2 cm proximal to the main carina at the lateral wall of the trachea (arrow), indicating the tracheal bronchus.